Health Education Research最新文献

Health-care professionals (HCPs) are key trusted figures in addressing coronavirus disease 2019 (COVID-19) challenges. They are thought to influence others' health decisions by personal example. However, during the COVID-19 crisis, some HCPs hesitated to be vaccinated. We examined factors contributing to that decision. We performed 12 semi-structured interviews, between February and May 2021, with Israeli HCPs who had declined or delayed COVID-19 vaccination. Three coders conducted a combined top-down and bottom-up analysis. We identified four main themes shaping vaccine decision-making: (i) sources of information, (ii) perceptions of necessity and risks of the vaccine, (iii) individual versus collective responsibility and (iv) political climate and media influence. Participants were worried about long-term effectiveness and safety, and while many agreed that high-risk populations should be vaccinated, all considered themselves to be at low risk for serious disease. Some felt they should avoid taking a perceived risk (accepting a new vaccine) to protect society, although they felt pressured to do so. Vaccination campaign politization and the way the media approached the subject also contributed to mistrust and hesitancy to be vaccinated. These findings help us understand HCP beliefs and uncertainties about COVID-19 vaccinations. This study can help inform future campaigns targeted at HCPs to promote the acceptance of vaccines.

This study assesses the ability of an online sexuality education (OSE) module ('You and Me') to enhance sexual and reproductive health (SRH) knowledge and attitudes among 10th-grade vocational high school students in China. We conducted a cluster randomized controlled trial, randomizing 29 vocational high schools to (i) receiving the module (intervention) or (ii) not receiving the module (control). Students completed a baseline questionnaire, then completed the module within 8 weeks and then completed a follow-up questionnaire within the following 2 weeks. We assessed the differences in intervention effects using hierarchical linear modeling. No significant differences between intervention and control groups were found for knowledge and attitude scores at baseline among the 2985 students included in the analyses. For the intervention group at follow-up, we observed significant improvements in SRH knowledge scores of approximately 20% for boys and girls although girls responded to the module with larger knowledge gains than boys. At follow-up, intervention group students also had higher SRH attitude scores toward views that are more contemporary than the control group. In addition, girls held more contemporary attitudes than boys. The comprehensive OSE module assessed is effective in improving SRH knowledge, and attitude among Chinese vocational high school students after the module is completed.

The effectiveness of e-cigarettes in smoking cessation is under debate. Informing smokers who are motivated to quit smoking about e-cigarettes may help them to make an informed decision about their use for smoking cessation, which, however, may also lead to unintended effects such as less quitting. This experimental study assessed the influence of providing tailored information about e-cigarettes in a web-based tailored smoking cessation intervention on participants' decision-making and smoking behavior. Adult smokers (N = 331) were randomized into a personalized eHealth intervention on (i) smoking cessation (control condition) or (ii) smoking cessation and information about e-cigarettes (intervention condition). Directly postintervention, participants in the intervention condition had more knowledge about e-cigarettes than participants in the control condition. Attitudes toward e-cigarettes were more positive among intervention participants than control participants, but the differences in attitude were less pronounced than the differences in knowledge and not consistent across items. At a 6-month follow-up, no between-condition differences were observed in the use of e-cigarettes as a smoking cessation method, the number of tobacco cigarettes smoked in the past 7 days, or other smoking outcomes.

The group at the highest risk of smartphone addiction is adolescents. In particular during the coronavirus disease 2019 pandemic, factors such as conducting education online, curfew and the increase in the monotonous time spent at home have led to an increase in the use of smartphones among adolescents. Therefore, this study aimed to determine the effect of the peer education model on reducing smartphone addiction in adolescents. The present semi-experimental study with a pre-test-post-test control group was carried out with 622 high school students in Turkey. The study was carried out between September 2021 and February 2022 in two stages. In the first stage, the peer educator education program on smartphone addiction in adolescents was implemented. In the second stage, the peer education program was implemented and monitored. While there was no significant difference between the intervention and control groups in terms of the mean scores they obtained from the Smartphone Addiction Scale at the pre-test (P > 0.05), the difference between them was statistically significant at the post-test (P < 0.001). This study demonstrated that the peer education model was effective in reducing smartphone addiction in adolescents. Thus, it can be recommended that school-based peer education programs for adolescents should be prepared and implemented.

This study examined whether knowledge of sexual consent buffers the relationship between risk factors for sexual violence (SV) and SV perpetration among first-year college men. The study data were drawn from a longitudinal study with 1144 first-year college men. A series of generalized linear models were conducted to examine whether knowledge of sexual consent moderated the relationship between SV risk factors and SV perpetration. Knowledge of sexual consent moderated the effect of hypermasculinity (P < 0.001), binge drinking (P < 0.001), rape-supportive social norms (P = 0.007) and peer support for SV (P < 0.001) such that there was a positive association between risk factors and SV perpetration among those with lower, but not higher, knowledge of sexual consent. Knowledge of sexual consent did not significantly moderate the relationship between SV perpetration and outcome expectancies for non-consensual sex (P = 0.387) and pornography use (P = 0.494). Knowledge of sexual consent may counteract risk factors for SV perpetration among young college men. The findings highlight the need for consent education to be incorporated in youth comprehensive sexual education to increase knowledge of sexual consent prior to college and campus-based SV prevention programming delivered to college students.

Project Extension for Community Healthcare Outcomes (ECHO) Nevada applied the ECHO virtual hub-and-spoke telementoring model over nine 6-week cohorts (between November 2019 and November 2021) supporting community health workers (CHWs) who advise clients with diabetes or pre-diabetes. This study describes the program implementation, including evaluation data collection efforts. Didactic topics included 'Intro to Healthy Eating and Easy Wins' to 'Grocery Shopping, Cooking Tips, Reading Labels, Meal Plans' and 'Reducing Bias and Being a Good Role Model'. Spoke participants signed up to review cases. Seventy-three of the enrolled participants (n = 100) attended three or more of the six sessions. Spoke participants completed 42 case presentations. The average self-efficacy increased from 2.7 [standard deviation (SD): 1.1] before completing the program to 4.1 (SD: 0.8) after completing the program. Average knowledge scores increased from 71 (SD: 16) before completing the program to 83 (SD: 14) after completing the program. Five group interviews drew actionable feedback that was incorporated into the program. Key elements of the ECHO model were successfully incorporated to support educational goals of a cohort of CHWs in nutritional coaching. Our program evaluation data tracking system shows non-significant but encouraging results regarding self-efficacy improvement and knowledge retention.

Waiting rooms provide an ideal location to disseminate health information. In this mixed-methods study, we evaluated waiting room-based health education talks at two clinics in the Dominican Republic and explored recommendations for implementing this intervention in similar settings. The talks addressed noncommunicable diseases, sexually transmitted infections, family planning and gender-based violence. We conducted pre- and posttests to assess attendees' change in knowledge and conducted semi-structured interviews with a subset of them. We conducted a semi-structured focus group with educators. Analyses included Wilcox Signed Rank Tests and McNemar tests for pre- and posttests, conventional content analysis for individual interviews and transcript coding for the focus group. Patient participants were 69.3% female aged 39.6 years (SD = 13.5) on average at one clinic (n = 127) and 100% female aged 17.4 (SD = 1.3) on average at the second clinic (n = 24). Focus group participants (n = 5) had 4.8 years (SD = 3.3) of health educator experience on average. Pre- and posttests showed significant improvement (P < 0.05) across all talks. Qualitative interviews emphasized engaging, clear and brief content delivery with visual aids. The focus group highlighted the importance of patient-centered design with culturally concordant delivery and identified implementation challenges. Findings demonstrate that waiting room-based education talks improve knowledge and provide suggestions for similar interventions.

American Indian (AI) communities experience persistent diabetes-related disparities, yet few nutrition interventions are designed for AI with type 2 diabetes or address socio-contextual barriers to healthy eating. We describe our process of adapting the evidence-based Cooking Matters® program for use by AI adults with type 2 diabetes in a rural and resource-limited setting in the North-Central United States. We conducted three focus groups with AI adults with diabetes to (i) identify Cooking Matters® adaptations and (ii) gather feedback on appropriateness of the adapted intervention using Barrera and Castro's cultural adaptation framework. Transcripts were coded using an inductive, constant comparison approach. Queries of codes were reviewed to identify themes. Contextual considerations included limited access to grocery stores and transportation barriers, reliance on government food assistance and the intergenerational burden of diabetes. Adaptations to content and delivery included incorporating traditional and locally available foods; appealing to children or others in multigenerational households and prioritizing visual over written content. Our use of Barrera and Castro's framework adds rigor and structure to the cultural adaptation process and increases the likelihood of future intervention success. Other researchers may benefit from using this framework to guide the adaptation of evidence-based interventions in AI communities.

Misinformation related to coronavirus disease 2019 (COVID-19) has the potential to suppress preventive behaviors that mitigate the spread of COVID-19. Early research on the behavioral consequences of COVID-19 misinformation is mixed, and most rely on cross-sectional data. We examined whether believing in COVID-19 misinformation at one time point influences engaging in preventive behaviors later. In addition, we investigated the role of trust in institutions. We conducted a two-wave survey in South Korea and examined the association between belief in COVID-19 misinformation at Wave 1 and preventive behaviors at Wave 2 controlling for preventive behaviors at Wave 1. We also analyzed whether there is an interaction between belief in COVID-19 misinformation and trust in institutions. Belief in COVID-19 misinformation at Wave 1 significantly increased avoidance of preventive behaviors at Wave 2, but after accounting for trust in institutions, this effect disappeared. Rather, trust in institutions significantly decreased avoidance of preventive behaviors. In addition, misinformation increased avoidance of preventive behaviors among those who trusted institutions the most. Results suggest that building trust in institutions is essential in promoting COVID-19 preventive behaviors. Belief in COVID-19 misinformation may have harmful effects, but these effects were pronounced for those who highly trust institutions.